Guidelines Issued for Recommending Metabolic Surgery

WEDNESDAY, May 25, 2016 (HealthDay News) -- Weight-loss surgery quickly improves glycemic control in patients with type 2 diabetes, and should be recommended or considered as a treatment for certain obese patients with diabetes, according to a report in the June issue of Diabetes Care.

The guidelines emerged from an international conference -- the Second Diabetes Surgery Summit -- held last fall in London. Evidence from 11 clinical trials and other sources shows that in most patients, surgery can either reduce glucose levels below diabetic thresholds or maintain adequate glycemic control despite major reduction in medication usage. Weight-loss surgery has been shown to improve glycemic control more effectively than any known drug treatment or lifestyle changes, the report authors said.

The new guidelines recommend weight-loss surgery to treat type 2 diabetes in patients with Class III obesity. The guidelines also recommend weight-loss surgery for those with Class II obesity with hyperglycemia that isn't adequately controlled by medication or lifestyle changes. Weight-loss surgery should also be considered to treat type 2 diabetes in people with a body mass index of 30 to 34.9 kg/m² with inadequate glycemic control.

In a journal news release, study author Francesco Rubino, M.D., of King's College London, said: "Surgery represents a radical departure from conventional approaches to diabetes. The new guidelines effectively introduce, both conceptually and practically, one of the biggest changes for diabetes care in modern times." He added that, "this change is supported by documented clinical efficacy and by the evidence of an important role of the gut in metabolic regulation, which makes it an appropriate target for anti-diabetes interventions."

Several authors disclosed financial ties to the biopharmaceutical and medical device industries.